Dawn M Coffman, P.A.
Individual provider Active NPI Medical Physician Assistant · Tyrone, GA
NPI 1437212834 · NPPES record last updated Dec 9, 2020
Key facts
- NPI
- 1437212834
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 002489 (GA)
- Practice address
- 190 Handley Rd Ste a
Tyrone, GA 30290-2178 - Phone
- (770) 997-5714
- Fax
- (770) 997-2844
- NPI assigned
- Dec 18, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Medical College of Georgia School of Medicine, 1993
- Medicare assignment
- May accept Medicare assignment
- Group practices
- WMC Tyrone LLC
Practice addresses (Care Compare)
190 Handley Rd
Suite a
Tyrone, GA 30290-2178
Phone (770) 997-5714
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.62 of 100
- Quality
- 83.25
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140619002511 | GA | Practitioner - Physician Assistant | 4587888284 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002489 | GA | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 002489 | GA | |
| Medical Physician Assistant | 363AM0700X | 002489 | GA | Yes |
Addresses
Primary practice location
190 Handley Rd Ste a
Tyrone, GA 30290-2178
Mailing address
190 Handley Rd Ste a
Tyrone, GA 30290-2178
Phone (770) 997-5714
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 218131000A | Medicaid | GA |
Other providers in Tyrone, GA
- Anna Taylor Chapman
- Madison Scott Chase
- Jemima NA Civil
- Ashley Danielle Clay
- Gabrielle Cobb
- Seth Lee Cohen
- Julian Coleman
- Color Me Therapy LLC
- Katherine Cook
- Cornerstone Caregiving East LLC
All providers in Tyrone, GA · Medical Physician Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.